Procedure
Radiotherapy is a cancer treatment in which, depending on the technique, different types of radiation are used to kill cancer cells. Radiation therapy is used for vulvar tumors if surgery is not possible due to the size of the tumor or other factors. Sometimes radiotherapy is also recommended before or after surgery. Radiotherapy is often combined with chemotherapy to improve its effectiveness. After radiotherapy, the patient does not emit any radioactivity and can return to her normal private life.
Curative radiotherapy is used for vulvar cancer in order to achieve a cure for the disease.
If the vulvar cancer has already spread, so-called palliative radiotherapy can prevent or alleviate the symptoms caused by metastases, e.g. in the lungs or bones.
Each patient is discussed in detail by a panel of experts from all relevant specialist areas in the so-called tumor board. After this discussion, the patient is presented with the optimal choice of treatment and her wishes and opinions are taken into account. Personal support is a matter of course for us.
Types of radiotherapy for vulvar cancer
Two types of radiotherapy can be used for vulvar cancer: radiation from the outside and radiation from the inside.
In external radiation therapy, a linear accelerator is used to send focused high-energy X-rays onto the tumor from the outside, killing it in a targeted manner. External radiation therapy is carried out as an outpatient treatment, does not require anesthesia and can be easily integrated into everyday private and professional life. The treatments are not painful and only take a few minutes each. As a rule, treatment is fractionated, which means that the radiation dose is divided into daily fractions. The treatment takes place five times a week over a period of approx. 6 weeks. The USZ uses only the most modern technology to achieve a personalized and precise dose distribution in the tissue.
Sometimes it is recommended to combine external radiotherapy with internal radiotherapy. Radiotherapy from the inside, also known as internal radiotherapy or brachytherapy , requires a short inpatient stay in our department. Brachytherapy is a clinical and scientific focus of Primoz Petric, an internationally recognized expert in this field, who passes on his knowledge at international congresses, courses and through publications. During brachytherapy, the radiation source is inserted into the cervix under brief anesthesia or sedation and destroys the tumor cells at close range. The radiation only travels a short distance, so that healthy tissue in the vicinity does not receive a high dose and is optimally protected. After the treatment, the source is removed from the body and the patient does not emit any radioactivity, so she can leave the hospital and return to her normal private life. Typically, four such treatments are required to achieve the best effect. The USZ uses the latest technology of magnetic resonance or computer tomography-guided brachytherapy. This technique enables highly precise and personalized delivery of the radiation dose to the tumor and maximum protection of healthy tissue.
The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise and low side-effect irradiation of vulvar cancer. State-of-the-art equipment and experienced medical staff contribute to treatment of optimum quality and safety.
You will be looked after by internationally recognized experts in the research and treatment of gynaecological cancer. The irradiation of gynecological cancer with a modern magnetic resonance guided technique is a clinical and scientific focus of Prof. P. Petric. He passes on his knowledge in a variety of international courses and congresses.
Our team works closely with our colleagues in gynecology and medical oncology to guarantee “one-stop” treatment.
In clinical studies, we are continuously working on improving the treatment of vulvar cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
In the following, we will describe radiotherapy for the different types and stages of cervical cancer.
Early stage vulvar cancer
The majority of patients with early-stage vulvar cancer are treated surgically. In some cases, the cancer may have characteristics that are associated with an increased risk of recurrence. In these cases, additional radiotherapy may be recommended to improve the treatment outcome, reduce the risk of relapse and increase the chances of recovery. In these cases, five weeks of external radiation therapy is typically recommended.
Surgical intervention can also be avoided in selected cases of early-stage vulvar cancer. In this case, the patient receives 5 weeks of organ-preserving external radiotherapy with simultaneous chemotherapy, followed by an additional 2 weeks of external radiotherapy or brachytherapy (usually four applications).
The chances of recovery with surgery (with or without additional radiotherapy) and combined radiotherapy and chemotherapy without surgery are comparable and excellent. However, they differ in terms of treatment duration and side effects. We always involve our patients in the decision-making process in order to tailor the treatment to their individual needs.
In clinical studies, we are continuously working on improving the treatment of vulvar cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
Locally advanced stage of vulvar cancer
In locally advanced stages, patients are typically treated with a combination of surgery and approximately five weeks of radiotherapy with simultaneous chemotherapy. Radiotherapy and chemotherapy can also be used before surgery to shrink the tumor and make surgery easier, or after surgery to destroy potential small post-operative tumor remnants.
Combined radiotherapy and chemotherapy is the treatment of choice for very advanced tumors or concomitant diseases where surgery is not recommended or not desired. In such cases, the patient receives five weeks of external radiotherapy with chemotherapy, followed by an additional two weeks of external radiotherapy or brachytherapy (usually four applications).
We always work closely with our colleagues in gynecology and medical oncology to provide each of our patients with the most modern and personalized treatment.
In clinical studies, we are continuously working on improving the treatment of vulvar cancer in order to make it even more effective and tolerable. To the overview of currently open studies.
Metastases of vulvar cancer, e.g. in the brain or bones
Cancer of the vulva is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.
For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery.
Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic vulvar cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.
State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.
In clinical studies, we are continuously trying to improve the treatment of vulvar cancer in order to make it even more effective and tolerable.
